Esbriet® (pirfenidone) may be different from other medicines you’ve taken in the past because it is considered a specialty medicine. This means that the medicine gets delivered to your home by a specialty pharmacy. Before that happens, there are a few steps you should complete.
Our team is here to help you get started and support you every step of the way.
As you start treatment with Esbriet, you may have questions. The Esbriet® Inspiration Program™ is a free resource designed to help you as you start and continue on your treatment journey.
When you enroll, you will receive:
*Clinical Education Managers are Genentech employees who educate about IPF and Esbriet, and the nurse support line is sponsored by Genentech. Both patient support resources do not provide medical advice to patients. If you have questions about your health or treatment, you are encouraged to contact your healthcare provider.
You are not alone. Many people have concerns about treatment costs. Rest assured that Esbriet is covered by most health insurance plans.1 However, it is important you understand your specific health insurance benefits and plan restrictions.
Even with health insurance, you might feel concerned about the cost of your treatment. If you are eligible, there may be ways to help you pay for your Esbriet:
§Eligible patients will pay as little as $5 per valid prescription, subject to a maximum benefit of $25,000 for a 12-month period.
Reference: 1. Zitter Health Insights. Policy & Access Tracking Tool for Idiopathic Pulmonary Fibrosis. Published September 2017.
This helpful brochure has more information about each of the steps you'll take
as you start treatment with Esbriet, along with an easy-to-use checklist.
†Independent co-pay assistance foundations have their own rules for eligibility. We cannot guarantee a foundation will help you. We only can refer you to a foundation that supports your disease state. We do not endorse or show financial preference for any particular foundation. The foundations we refer you to are not the only ones that might be able to help you.
‡The Medicare Extra Help program is not a Genentech program. It is administered by the Social Security Administration. The co-pay amount for Medicare Extra Help changes each year.
||This Esbriet $5 Co-pay Program is valid ONLY for patients with commercial insurance who have a valid prescription for a Food and Drug Administration
(FDA)-approved indication of a Genentech medication. Patients using Medicare, Medicaid or any other federal or state government program to pay for their medications are not eligible.
Under the program, the patient will pay a co-pay. After reaching the maximum program benefit, the patient will be responsible for all out-of-pocket expenses.
All participants are responsible for reporting the receipt of all program benefits as required by any insurer or by law. No party may seek reimbursement for all or any part of the benefit received through this Program. The program is only valid in the United States and U.S. Territories. This program is void where prohibited by law and shall follow state restrictions in relation to AB-rated generic equivalents (e.g., MA, CA) where applicable. The patient, guardian, prescriber, hospital and any other person using the program agree not to seek reimbursement for all or any part of the benefit received by the patient through the offer of this program. Genentech reserves the right to rescind, revoke or amend the program without notice at any time. Additional terms and conditions apply. Please visit EsbrietCopay.com for the full list of Terms and Conditions.
¶To be eligible for free Genentech medicine from the Genentech Patient Foundation, insured patients who have coverage for their medicine must have exhausted all other forms of patient assistance (including the Esbriet $5 Co-pay Program and support from independent co-pay assistance foundations) and must meet certain financial criteria. Uninsured patients and insured patients without coverage for their medicine must meet different financial criteria.
Centers for Medicare & Medicaid Services. Advance notice of methodological changes for calendar year (CY) 2018 for Medicare Advantage (MA) capitation rates, Part C and Part D payment policies and 2018 call letter. https://www.cms.gov/Medicare/Health-Plans/MedicareAdvtgSpecRateStats/Downloads/Advance2018.pdf. Posted February 1, 2017. Accessed October 17, 2017.
Centers for Medicare & Medicaid Services. Advance notice of methodological changes for calendar year (CY) 2018 for Medicare Advantage (MA) capitation rates, Part C and Part D payment policies and 2018 call letter. https://www.cms.gov/Medicare/Health-Plans/MedicareAdvtgSpecRateStats/Downloads/Advance2018.pdf. Posted February 1, 2017. Accessed October 17, 2017.
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